MEDICARE: LIGHTNING MEDICAL CENTER CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1851178131
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIGHTNING MEDICAL CENTER CORP

Provider Business Mailing Address
First Line	:	8338 N ARMENIA AVE STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-2777
Country	:	US
Telephone Number	:	813-402-2737
Fax Number	:

Provider Business Practice Location Address
First Line	:	8338 N ARMENIA AVE STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33604-2777
Country	:	US
Telephone Number	:	813-402-2737
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAQUEL OLIVA
Credential	:
Telephone Number	:	813-317-9944

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	09/11/2023

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Directions to “LIGHTNING MEDICAL CENTER CORP ” Practice Location

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